Addressing the Triple Aim Through LTACH, Payer, and Health Plan Partnership

Saleem Alinur and Sharon Lee, vice presidents of managed care at Kindred Hospitals, discuss the benefits of payers and health plans partnering with LTACHs to meet their goals of improving population health, patient experience, and cost efficiency.

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Welcome back to PopHealth Perspectives, a conversation with the Population Health Learning Network where we combine expert commentary and exclusive insight into key issues in population health management and more.

Today we speak with Saleem Alinur and Sharon Lee from Kindred Hospitals. Thank you for joining us today. Can you both introduce yourselves?

Sharon Lee: Hi everyone. My name is Sharon Lee. I'm the Vice President of Managed Care for the West Division. I am based out of California. I've been in the managed care arena for over 20 years, basically on the provider side.

Saleem Alinur: Hello, I'm Saleem Alinur, the Vice President of Managed Care for Kindred’s East District. My background is primarily on the payer side with some emphasis on the provider side as well.

Thanks, Sharon and Saleem. We're here today to talk about challenges that health plans and payers are facing and how long-term acute care hospital partnership can be an important strategy in overcoming them. Saleem, can you tell us a little more about challenges health plans and payers are facing today?

Mr Alinur: Sure. At Kindred Hospitals, we work and partner with many of the payers across the country, and they have communicated to us several challenges they're facing. First is the rising cost of health care, which results in payers needing partners that can provide high quality care at a reduced cost. As a result of these rising costs, health plans are also having to take more financial risks when managing their members’ health care needs.

Payers are also struggling with financial outliers, such as increased length of stay and readmission rates, which result in driving up total cost of care for their members. Some examples include patients with sepsis and respiratory failure.

In addition, there's a lack of availability of downstream providers due to limited clinical capabilities and staffing, usually. These are just some of the challenges payers have come to us looking for solutions to try to help them on.

How can long-term acute care hospitals, or LTACHs, help payers address these issues?

Mr Alinur: The role of an LTACH is to offer additional acute care to complex patients coming out of a medical-surgical or intensive care unit setting who still need physician-led acute care. LTACHs like Kindred are tuned into the triple aim that payers have, and we partner to help them achieve that. The triple aim essentially describes a 3-pronged approach for achieving the ultimate goal of optimizing the performance of the health care system. The 3 components are population health, patient experience, and cost per capita.

Let's take each one of those individually. Sharon, how can LTACHs help improve population health?

Ms Lee: At an LTACH, we are focused on helping the most medically complex patients to recover. One way we do that is through care transition programs that allow for the early identification of patients with complex or chronic conditions, like sepsis, so that we make sure patients get the right level of care in a timely manner.

And Saleem, what can LTACHs do to improve patient experience?

Mr Alinur: LTACHs like Kindred provide patient-centered care even after they leave the facility. For example, with postdischarge follow-up programs, we are reaching out to patients multiple times after they discharge from our hospital, regardless of where they're discharged to. We want to make sure that they are doing well and have their questions answered, and we want to make sure they understand their discharge orders so they're less likely to readmit into an acute care setting.

Lastly, Sharon, how can LTACHs help decrease cost per capita?

Ms Lee: Since LTACHs provide very focused care, we are able to streamline resources, making us the most cost-effective acute care setting available to medically complex patients. Additionally, by providing these patients with specialized acute care, they are able to recover more quickly and more completely, meaning fewer costly readmissions.

Thank you, Sharon. Is there anything else either of you wants to add?

Ms Lee: Yes. These are just a few examples of how LTACHs keep the triple aim front and center in our minds. LTACHs like Kindred are committed to partnering with health plans and payers so they can achieve their goals of improving outcomes, patient experience, and cost efficiency in this very challenging environment.

Thank you both for joining us today to discuss important difficulties in the health plan space and how long-term acute care hospitals can be beneficial partners in addressing these pain points.

Thanks for tuning in to another episode of PopHealth Perspectives. For similar content, or to join our mailing list, visit populationhealthnet.com.

This transcript has been edited for clarity.